BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

Since the publication of the first volume in 1993, the Routledge History of Western Philosophy has established itself as the most comprehensive chronological survey of the history of western philosophy available. The final volume is being published in March 1999, completing the history from its beginnings in the sixth century B.C. to the present. Key features of the series: * Includes in-depth discussion of all major philosophical developments and philosophers * Is compiled by prestigious editors leading an international team of (...) over 100 specialists giving wide-ranging, balanced coverage * Each volume contains an index, a detailed bibliography, a glossary of technical terms and a chronological table to set the philosophical developments in context * Each chapter is written by an acknowledged authority in the field * Provides an essential resource for students, teachers and researchers in philosophy. The Routledge History of Philosophy is available either as separate volumes or as a complete 10 volume set. For more details on the Routledge History of Philosophy please contact us at our London address. (shrink)

Canada’s Medical Assistance in Dying (MAID) legislation changed in 2021; persons without a reasonably foreseeable natural death (RFND) could now be eligible for MAID and would have to wait at least 90 days before their intervention. This legislative change caused a new ethically complex question to arise, which we explore in this commentary, namely: Where should individuals without a RFND wait (for 90 days) in a publicly funded health system?

The aim of UK-REACH (“The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers”) is to understand if, how, and why healthcare workers (HCWs) in the United Kingdom (UK) from ethnic minority groups are at increased risk of poor outcomes from COVID-19. In this article, we present findings from the ethical and legal stream of the study, which undertook qualitative research seeking to understand and address legal, ethical, and social acceptability issues around data protection, privacy, and information (...) governance associated with the linkage of HCWs’ registration data and healthcare data. We interviewed 22 key opinion leaders in healthcare and health research from across the UK in two-to-one semi-structured interviews. Transcripts were coded using qualitative thematic analysis. Participants told us that a significant aspect of Big Data research in public health is varying drivers of mistrust—of the research itself, research staff and funders, and broader concerns of mistrust within participant communities, particularly in the context of COVID-19 and those situated in more marginalised community settings. However, despite the challenges, participants also identified ways in which legally compliant and ethically informed approaches to research can be crafted to mitigate or overcome mistrust and establish greater confidence in Big Data public health research. Overall, our research indicates that a “Big Data Ethics by Design” approach to research in this area can help assure (1) that meaningful community and participant engagement is taking place and that extant challenges are addressed, and (2) that any new challenges or hitherto unknown unknowns can be rapidly and properly considered to ensure potential (but material) harms are identified and minimised where necessary. Our findings indicate such an approach, in turn, will help drive better scientific breakthroughs that translate into medical innovations and effective public health interventions, which benefit the publics studied, including those who are often marginalised in research. (shrink)

R K Elliott; Aestheticism, Imagination and Schooling: a reply to Ruby Meager, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 33–42.

Clinical and Care Bioethics Committees at Public and Private Healthcare Institutions of Medium and High Complexity Levels in Cities of the Atlantic Coast of Colombia Comitês de Bioética clínico-assistencial nas instituições de saúde públicas e privadas dos níveis de média e alta complexidade das cidades da Costa Atlântica da Colômbia Care bioethics committees are interdisciplinary groups engaged in providing education to members of said committees, all the staff in the hospital —including professors and students in their internship—, and members of (...) the community. The objective of this study is to determine the situation of clinical and care bioethics committees at healthcare institutions in the Atlantic Coast of Colombia between 2010-2016. The study is cross-sectional, descriptive, and retro-prospective. Twenty-six health institutions that met the inclusion criteria were selected and administered a semi-structured survey. The statistical software SPSS version 22 was used to analyze the information. This study adhered to ethical research guidelines. The name most commonly given to committees is Hospital Ethics Committee. Only half have staff trained in ethics or bioethics and the most outstanding function is education in ethics; however, in the same percentage there are committees whose opinion is divided as their operation is unclear. Committees should follow existing ethical and bioethical models, and bills should be brought forward to help committees at healthcare institutions become more effective as regards their structure and operation. Para citar este artículo / To reference this article / Para citar este artigo Carrillo González S, Lorduy-Gómez J, Muñoz-Baldiris R. Comités de Bioética Clínico-Asistencial en las instituciones de salud públicas y privadas de los niveles de mediana y alta complejidad de las ciudades de la Costa Atlántica de Colombia. Pers Bioet. 2019; 23: 122-136. DOI: https://doi.org/10.5294/pebi.2019.23.1.8 Recibido: 23/08/2018 Aceptado: 25/02/2019. (shrink)

The target article is an attempt to make some progress on the problem of color realism. Are objects colored? And what is the nature of the color properties? We defend the view that physical objects (for instance, tomatoes, radishes, and rubies) are colored, and that colors are physical properties, specifically types of reflectance. This is probably a minority opinion, at least among color scientists. Textbooks frequently claim that physical objects are not colored, and that the colors are "subjective" or "in (...) the mind." The article has two other purposes: first, to introduce an interdisciplinary audience to some distinctively philosophical tools that are useful in tackling the problem of color realism and, second, to clarify the various positions and central arguments in the debate. (shrink)

A critique of LaPorte's views on chemical kinds, like jade and ruby, is presented. More positively, a new slant is provided on the question of whether elements are natural kinds. This is carried out by appeal to the dual nature of elements, a topic that has been debated in the philosophy of chemistry but not in the natural kinds literature. It is claimed that the abstract notion of elements, as opposed to their being simple substances, is relevant to the (...) Kripke–Putnam approach to natural kinds and to some criticisms that have been raised against it, although I do not support the K–P account. The proposed view avoids the traditional microstructuralist approach to natural kinds. The article also addresses the question of whether natural kinds concern metaphysical or epistemological considerations. Recent attempts by chemists to modify the periodic table are brought to bear on the question of classification and consequently on whether the identification of elements is interest dependent. (shrink)

There are good arguments for examining great ape communicative achievements for what they contribute to our understanding of great ape cognition and its evolution (Russon & Begun, in press a). Our concern is whether Shanker & King's (S&K's) thesis advances communication studies from a broader cognitive and evolutionary perspective.

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.4 (2001) 391-400 [Access article in PDF] Bioethics Inside the Beltway A Shooting on Capitol Hill: "The Ruby Satellite System," Mental Illness, and Failure of the American Legal System Peter J. Cohen On 24 July 1998, Russell Eugene Weston, Jr., stormed the United States Capitol, forced his way through a security checkpoint, bypassed a metal detector, and entered the office complex of Representative (...) Tom DeLay (R-TX), the House Majority Whip (Weil 1998). During this period of terror, he shot and killed two officers of the Capitol Police and seriously wounded another as they attempted to end his foray. 1 Weston was severely wounded by several Capital police officers and taken into custody. After being treated for his injuries, he was incarcerated in the District of Columbia. 2On 5 May 1999, Weston was transferred to the Federal Correctional Institute in Butner, North Carolina (United States v. Weston, 69 F. Supp. 2d 99 (D.D.C. 1999), 103), where he remains to this day. He has neither been brought to trial nor received appropriate psychiatric therapy, but continues to be warehoused "in solitary confinement under constant observation... in a psychotic state (United States v. Weston, 255 F.3d 873; LEXIS 16851 (U.S. App. 2001b), 3-4 [LEXIS]). I will briefly detail the legal events responsible for this mad situation and suggest alternative actions that should have been taken at the very onset of the case. Early Chronology Although overtly the crime appeared to be senseless and without any conceivable motivation, Weston believed that his acts were justified and necessary. The story he told to the court-appointed forensic psychiatrist, Sally C. Johnson, M.D., 3 was that while working for NASA in the early 1980s, he had developed a "Ruby Satellite System," a powerful machine that could reverse time. With access to this system, nothing was permanent--the user could simply reverse time and exit from the current scene. However, the "System" was now controlled by cannibals who were developing and spreading "Black Heva," the deadliest disease known to [End Page 391] humankind, similar to HIV or the plague. It resulted from human corpses rotting and turning black. Time was running out, and Weston believed he had to return to override the "Ruby Satellite System" in the Capitol so that he could stem the spread of "Black Heva" and prevent world calamity. He believed that if he were tried, convicted, and even executed, he could simply time reverse himself, place himself in a safe within the Capitol, and subsequently resume his life at whatever point he chose (United States v. Weston, 206 F.3d 9 (D.C. Cir. 2000), 19-20).On 22 April 1999, the district court accepted Dr. Johnson's diagnosis that Weston suffered from paranoid schizophrenia, the symptoms of which were so severe that he would be incapable of understanding the proceedings against him and of assisting in his own defense. On this basis, the court had no difficulty in finding him incompetent to stand trial (U.S. v. Weston 1999, 102).At Weston's initial hearing, Dr. Johnson had testified that medication would be efficacious in treating Weston's delusions: [T]he standard of care in someone suffering from this type of symptom picture would be to treat them with medication.... [T]here is a good likelihood that he'll have a positive response, positive in the sense that his symptoms will diminish in response to treatment.... The potential benefits to treating the defendant far outweigh the risks.... (U.S. v. Weston 1999, 108) The defense presented no expert testimony refuting Dr. Johnson's presentation. The district court then ordered that Weston begin receiving medication in order to render him nondangerous and competent for trial (U.S. v. Weston 1999, 108-9). The Problem Weston refused to be medicated! 4 He has continued to claim that the administration of antipsychotic drugs against his will would violate his Fifth Amendment due process liberty interest in avoiding unwanted bodily intrusion and implicated... (shrink)

Este es un libro sobre la libertad y sobre la verdad. Y ahora ya podéis reír. Pero no os protejáis en la risa sarcástica, permitíos una risa impertinente. La libertad y la verdad son dos formas de impertinencia necesaria, cuando hemos comprendido que no somos realmente libres ni escaparemos nunca del error ni del engaño. De esto hablan estos textos, y lo hacen de la mano de diversos autores y personajes que han hecho de su impertinencia una forma de pensamiento. (...) Georg Büchner nos presenta a Danton y a Robespierre conversando ante la guillotina. Diderot y Sophie Volland escriben su amor en una eternidad sin Cielo. Joaquim Jordà filma a sus amigos mientras colectivizan la fábrica Numax y Teresa de Ávila corta cebollas en la cocina mientras charla con su inquisidor... El 'Torete' de Perros callejeros, Christa Leem, Ixiar Rozas o Santiago López Petit desafían la noche. Se añaden a ellos Albert Camus, conjurando la mentira, y los muertos de las comedias de Eduardo de Filippo, porque todo está lleno de muertos. Entre ellos y muchos más que recorren estas páginas, destaca la voz de mi abuela, Concepció Rubiés i Trias, quien vuelve directamente a nosotros a través de las cartas que escribió cuando tenía dieciocho años y se marchó al exilio. Todas estas voces organizan una cacofonía que es, para mí, una fiesta de la inteligencia, en un tiempo en el que se ha hecho muy difícil sentir la alegría de pensar. Las malas compañías no se escogen, pero se puede decidir seguirlas o no. A mí, siempre me han llevado por buen camino. (shrink)

In 1962 appeared one of the classic articles in Anglo-Saxon manuscript studies, the publication of two eleventh-century fragments of leaves of Old English found in the binding of a seventeenth-century printed book in the library of the University of Kansas, Lawrence. The fragment that more nearly concerns the present article now carries the shelf mark Pryce MS C2:1 in the Kenneth Spencer Research Library . It is a large part of a single leaf from The Legend of the Holy Cross (...) before Christ, an edifying work known in full only in a twelfth-century copy, Oxford, Bodleian Library, MS Bodley 343, fols. 14v–20v . Working from a photograph the great paleographer and codicologist N. R. Ker attributed the hand of the Kansas fragment to the scribe who also wrote the texts of two bits of the same work found in the library of Matthew Parker, archbishop of Canterbury , at Corpus Christi College, Cambridge, now MS 557 . He concluded, no doubt rightly, that all three are part of one manuscript. (shrink)

In his 1947 British Academy lecture on Naturalistic Ethics, Mr. W. F. R. Hardie is concerned to ask himself whether a naturalistic theory of ethics can give a “satisfactory account of our moral knowledge or convictions,” or whether some form of non-naturalism is demanded by our moral experience. It will be remembered that after a careful sifting and examination of certain features of our moral knowledge or convictions, Mr. Hardie suspends judgment between naturalism and non-naturalism, observing that “on the one (...) hand philosophers who start from the ostensible facts of our moral experience and thinking, and are most careful and accurate in their rendering of these facts, have tended to be led to objectivist and anti-naturalistic conclusions. Where they least carry conviction is in the moral epistemology which they assume or defend. When we reflect, with the epistemological issue in mind, on the actual process in ourselves of moral reflection and decision, we are more inclined to sympathize with a ‘moral sentiment’ theory than we ought to be if the rationalists are wholly in the right.” In what follows I wish to consider another feature of our moral experience which Mr. Hardie did not examine in his lecture and which appears to be of considerable importance, namely the situation where, to put it very roughly for the moment, we find ourselves at variance with another person or persons on a moral issue, where, for instance, I hold that a certain course of conduct is right, and the other person or persons hold that it is wrong, or vice versa , and where further we may pursue divergent courses of action accordingly. I wish to ask myself whether the naturalistic commentary on this situation of ethical disagreement is altogether satisfactory when we consider it in the light of “the ostensible facts of our moral experience and thinking,” whether, in fact, to use another phrase of Mr. Hardie's, it squares altogether with “our fundamental moral convictions” in regard to such a situation. The naturalistic commentary with which I am primarily concerned is that which is now sometimes labelled “the emotive theory of ethics,” and is to be found admirably developed, for example, in Professor Stevenson's book Ethics and Language. (shrink)

In his very interesting book The Grounds of Moral Judgement, Dr. G. R. Grice tries to reconstitute contract theory so as to give an account of morality such that moral requirements can be explained in terms of what he calls the contract ground. He wants to go on and argue from this that it is irrational to be immoral, but my concern lies immediately with the contract ground. I think that faults can be found in the setting up of the (...) contract ground, which is the core of Grice's theory. (shrink)

R. A. Sharpe; VIII*—Art and Expertise, Proceedings of the Aristotelian Society, Volume 85, Issue 1, 1 June 1985, Pages 133–148, https://doi.org/10.1093/aristote.

Among Plato's later dialogues, the _Parmenides_ is one of the most significant. Not only a document of profound philosophical importance in its own right, it also contributes to the understanding of Platonic dialogues that followed it, and it exhibits the foundations of the physics and ontology that Aristotle offered in his _Physics_ and _Metaphysics _VII. In this book, R.E. Allen provides a superb translation of the _Parmenides_ along with a structural analysis that procedes on the assumption that formal elements, logical (...) and dramatic, are important to its interpretation and that the argument of the _Parmenides_ is aporetic, a statement of metaphysical perplexities. Allen's original translation of and commentary on the _Parmenides_ were published in 1983 to great acclaim and have now been revised by the author. (shrink)

Kur’an’ın kendine has birbiriyle irtibatlı kelimeler dünyası bulunmakta-dır. Doğru bir Allah tasavvuru, Allah-âlem, Allah-kul, âlem-kul ilişkisinin nasıl olması gerektiği bu kelime dünyası tarafından anlatılmaktadır. Bu nok-tada Kur’an’da herhangi bir konu anlatılırken aralarında sıkı irtibat olan kelime grupları kullanılmıştır. Örneğin Allah Kur’ân’da kendisini, Rakîb, Alîm, Basîr, Habîr, Latîf vb. lafızlarla insanın idrakine yansıtmakta ve böylece doğru bir Allah Tasavvuru oluşmasını amaçlamaktadır. Bu çalışmada, öncelikle ra-ka-be /رقب kökünün etimolojisi üzerinde durulacaktır. Zira bir kelimenin dildeki asli anlamı ve türevleriyle beraber sonradan kazandığı anlamların (...) tespiti, ilgili kelimenin anlam sahasını keşfetme ile mümkündür. Akabinde bu kökün türevlerinden “Rakîb” kelimesi ile anlam ilişkisi olan ve Yüce Allah’ın Kur’ân’da kendisine nispet ettiği sıfatlarından, Alîm, Basîr, Habîr, Şehîd kelimeler tahlil edilecektir. Bu bağlamda doğrudan olmasa da dolaylı olarak Allah’ın görmesini ve gözetlemesini ifade eden kelimelere ve ilgili âyetlere yer verilecektir. Böylece ra-ka-be kökünün Kur’an siyakındaki anlam sahası ortaya konulmuş olacaktır. (shrink)

This chapter discusses the conceptual orbitings of individuals corresponding to lists of noun phrases formed with ‘or’. We should resist the precept that a set-theoretic union must be contrived for every occurrence of ‘or’ in favour of some discourse-theoretical account that codifies the work that ‘or’ does in the punctuation of speech. A succession of sentences composed with ‘or’ is replaced by a succession of forms containing non-assertive occurrences of those sentences either composed with ‘and’ or as separate acts of (...) speech. The discussion of the behaviour of ‘or’ may be taken up in intensional environments where Quine left the subject of the opacity of certain verbs. The degree of particularity of the intentions is reflected in the particularity with which the dative pronoun will permit existential generalization. (shrink)

Cette étude vise dans l'ensemble à définir correctement l'idéalisme de J. G. Fichte en analysant sa pensée dans sa relation avec l'empirisme logique. Il se peut qu'il existe des sentiments inexprimables, mais toute pensée scientifique doit s'énoncer. Or il n'est point d'énoncé qui ne soit étayé par la raison dans son objectivité principielle. C'est cette même raison qui assure à l'objet empirique une vérité que par lui-même il ne possède pas. L'empiriste croit, se fondant, si l'on peut dire, sur le (...) donné plus que fluctuant des sensations, parvenir, par une induction que rien ne justifie, à conférer à son objet une consistance plus relevée. Prédécesseur de Husserl, mais aussi de Whewell, Fichte montre que la raison est immanente à l'expérience comme visée et pouvoir d'universalité. Loin que le monde soit un rêve, c'est la demeure de l'esprit. Aussi, se plaçant sur le terrain de l'empirisme, l'auteur de la Doctrine de la Science parvient à renverser les rôles : le rêveur est l'empiriste. L'auteur de l'article, dont l'éloge n'est plus à faire, a voulu montrer en rassemblant des textes qui appartiennent aux différentes étapes de la progression philosophique de Fichte la constance fondamentale de cette orientation qui veut qu'il n'existe de réalisme vrai que par l'esprit. (shrink)

The present research work highlights the basic concepts of Ethics and Philosophy of the Visistadvaita School of Thought of Ramanuja. The Sankalpasuryodaya an Allegorical drama is composed by Vedanta Desika [1268-1369 AD] a great exponent in the history of the field of Visistadvaita School. This work contains Date, Life and Works of the Author; Place of Allegorical Dramas in Sanskrit Literature; Summary of Sankalpasuryodaya; A Literary Analysis of the Drama, Philosophical Doctrines Reflected in the Drama; and An Evaluation. This detailed (...) research study of the Sankalpasuryodaya contributes a systematic symbolism by which abstractions of ethics, religion and philosophy of Ramanuja Vedanta are represented as accurately as possible through significant characters, plots and contexts with identification of comprehensive names. (shrink)